Provider Demographics
NPI:1275712077
Name:LAURA L ALLMAN LCSW LTD
Entity Type:Organization
Organization Name:LAURA L ALLMAN LCSW LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-961-9166
Mailing Address - Street 1:1421 GREENMOUNT ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-3027
Mailing Address - Country:US
Mailing Address - Phone:815-961-9166
Mailing Address - Fax:815-964-5216
Practice Address - Street 1:1421 GREENMOUNT ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-3027
Practice Address - Country:US
Practice Address - Phone:815-961-9166
Practice Address - Fax:815-964-5216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL513906OtherVALUEOPTIONS
IL10132090OtherBCBS OF IL
IL2145319OtherCIGNA
IL60054OtherAETNA
IL211264Medicare PIN